Provider Demographics
NPI:1992356414
Name:ANDERSON, RACHAEL ANN (NP-C)
Entity type:Individual
Prefix:
First Name:RACHAEL ANN
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1083
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22555-1083
Mailing Address - Country:US
Mailing Address - Phone:540-300-2026
Mailing Address - Fax:716-214-3792
Practice Address - Street 1:206 FORESAIL CV
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-2525
Practice Address - Country:US
Practice Address - Phone:540-300-2026
Practice Address - Fax:716-214-3792
Is Sole Proprietor?:No
Enumeration Date:2019-09-25
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024178097363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner